Quality Assurance and Performance Improvement
Background : Sterile Processing Departments (SPD) play a critical role in patient safety by proper sterilization of surgical instruments. Infection Preventionists (IPs) are often responsible for overseeing Infection Control (IC) standards for SPD, but frequently lack training in sterile processing that can create challenges. In 2015 we developed a quality improvement project improving IP knowledge of SPD processes and compliance with IC measures.
Methods : An audit tool was created utilizing observations, staff responses to IC questions and documentation review. To gain familiarity with SPD processes and improve audits, IPs attended weekly SPD meetings, Skills Fairs, APIC webinars and professional conferences . Audits were developed from nationally recommended practices, done bimonthly by IC personnel and reviewed quarterly with SPD leadership. IPs provided education for staff when gaps were identified. Implementation of SPD audits occurred concurrently with other OR quality improvement projects to facilitate improved instrument reprocessing
Results : Average overall audit scores increased in the first year from 67% in 2015 to 84% in 2016 (p < 0.001 by Chi squared test). Although overall average audit scores remained consistent since 2016, scores for questions related to employee knowledge of cleaning technique increased from 59% in 2015 to 90% in 2018 (p < 0.001). We observed a correlation between increasing SPD audit scores and decline in bioburden events from a yearly average of 3.29 events per 1000 procedures in 2015 to 1.15 events per 1000 procedures in 2018 (p < 0.001).
Conclusions : By attending SPD conferences, staff meetings, and skills fairs, IPs developed an audit tool to improve SPD oversight. Frequent auditing and education improved audit scores and correlated with an improvement in SPD function, as measured by decreased bioburden events. This project demonstrates how collaboration between the IP and SPD departments can lead to improved compliance and patient safety.